ASSESSING FEMALE MALE GENITALIAS Including The INGUINAL

ASSESSING FEMALE &
MALE GENITALIAS
including the INGUINAL
AREA & ANUS
Female Genitals and Inguinal Area (2 of 2)
• Responsibilities of nurse
• Assembling equipment
• Preparing client
• Supporting client during the procedure
• Monitoring and assisting client after procedure
• Documenting procedure
Lifespan Considerations Assessing the Female Genitals and
Inguinal Area (1 of 4)
Infants
• Infants can be held in a supine position on the parent’s lap with the
knees supported in a flexed position and separated.
• In newborns, because of maternal estrogen, the labia and clitoris may
be edematous and enlarged, and there may be a small amount of
white or bloody vaginal discharge.
• Assess the mons and inguinal area for swelling or tenderness that
may indicate presence of an inguinal hernia.
Children
• Ensure that you have the parent or guardian’s approval to perform the examination and
then tell the child what you are going to do. Preschool children are taught not to allow
others to touch their “private parts.”
• Girls should be assessed for Tanner staging of pubertal development (Box 30-9).
• Girls should have a Papanicolaou (Pap) test done if sexually active, or by age 18 years.
• The clitoris is a common site for syphilitic chancres in younger females.
Older Adults
• Labia are atrophied and flattened.
• The clitoris is a potential site for cancerous lesions.
• The vulva atrophies as a result of a reduction in vascularity, elasticity, adipose tissue, and
estrogen levels. Because the vulva is more fragile, it is more easily irritated.
• The vaginal environment becomes drier and more alkaline, resulting in an alteration of
the type of flora present and a predisposition to vaginitis. Dyspareunia (difficult or painful
intercourse) is also a common occurrence.
• The cervix and uterus decrease in size.
• The fallopian tubes and ovaries atrophy.
• Ovulation and estrogen production cease.
• Vaginal bleeding unrelated to estrogen therapy is abnormal in older
women.
• Prolapse of the uterus can occur in older females, especially those
who have had multiple pregnancies.
Skill 30-18 Assessing the Female Genitals and Inguinal Area (1 of
3)
3)
3)
For long description see slide 497, Appendix 152

Male Genitals and Inguinal Area
• External genitalia examined in matter-of-fact,
competent manner
• Hernia
• Protrusion of intestine through inguinal wall or canal
• Prostate gland
• Part of rectal exam
Lifespan Considerations Assessing the Male Genitals and Inguinal
Lymph Nodes (1 of 3)
Infants
• The foreskin of the uncircumcised infant is normally tight at birth and should not be
retracted. It will gradually loosen as the baby grows and is usually fully retractable by 2 to 3
years of age. Assess for cleanliness, redness, or irritation.
• Assess for placement of the urethral meatus.
• Palpate the scrotum to determine if the testes are descended; in the newborn and infant, the
testes may retract into the inguinal canal, especially with stimulation of the cremasteric
reflex.
• Assess the inguinal area for swelling or tenderness that may indicate the presence of an
inguinal hernia.
Children
• Ensure that you have the parent or guardian’s approval to perform the examination and
then tell the child what you are going to do. Preschool children are taught to not allow
others to touch their “private parts.”
• In young boys, the cremasteric reflex can cause the testes to ascend into the inguinal
canal. If possible have the boy sit crosslegged, which stretches the muscle and decreases
the reflex.
• Table 30-12 on page 594 shows the five Tanner stages of development of pubic hair,
penis, and testes/scrotum.`
Older Adults
• The penis decreases in size with age; the size and firmness of the testes decrease.
• Testosterone is produced in smaller amounts.
• More time and direct physical stimulation are required for an older man to achieve an
erection, but he may have less premature ejaculation than he did at a younger age.
• Seminal fluid is reduced in amount and viscosity.
• Urinary frequency, nocturia, dribbling, and problems with beginning and ending the
stream are usually the result of prostatic enlargement.
Figure 30-37 The Male Urogenital Tract
Skill 30-19 Assessing the Male Genitals and Inguinal Area (1 of 4)
Anus
• Included as essential part of every comprehensive
physical examination
• Inspect for color, integrity, lesions
Lifespan Considerations Assessing the Anus
Infants
• Lightly touching the anus should result in a brief anal contraction
(“wink” reflex).
Children
• Erythema and scratch marks around the anus may indicate a
pinworm parasite. Children with this condition may be disturbed by
itching during sleep.
Older Adults
• Chronic constipation and straining at stool cause an increase in the
frequency of hemorrhoids and rectal prolapse.
Skill 30-20 Assessing the Anus (1 of 3)

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ASSESSING FEMALE &

For long description see slide 497, Appendix 152

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